Medicines safety for older people

Your chance of problems with medicines increases as you age for two main reasons:

1. your body changes with age
2. you are more likely to be taking multiple medicines as you get older

Changes in your body

Your body changes in several ways as you age. For example, the amount of water, fat and muscle you have changes.

Because of these changes, you may:

• become more sensitive to your medicines
• not be able to process your medicines properly
• have difficulty getting rid of medicines from your body

You may also become more likely to get side effects and have interactions between your medicines.

Some health conditions that affect older people can make it more difficult to take your medicines. These include:

• poor eyesight which may make it hard to read the instructions on your medicine
• arthritis, which may make it hard for you to open your medicine packs
• memory loss, which may make it hard for you to remember to take your medicine.
• conditions that make it harder to swallow your medicines.

Polypharmacy (multiple medicines)

If you have a few chronic (ongoing) conditions you might be prescribed multiple medicines. When you take 5 or more medicines this is called polypharmacy.

If you take 5 or more medicines daily, you are:

• more likely to be taking medicines that can interact with each other
• more likely to take two medicines with overlapping or additive effects
• more likely to make a mistake with your medicines

Medicines can have side effects that might make you more likely to fall. Anticholinergic side effects are due to the unwanted effects of your medicine on the balance of chemicals in your body.

Symptoms you may notice include:

• changes to your balance and coordination
• dry eyes, mouth and skin
• constipation
• forgetfulness or confusion
• feeling unsteady or dizzy

These medicines include:

• antidepressants
• antipsychotic medicines
• anticonvulsants
• antihistamines
• medicines used for Parkinson's disease

Some medicines can increase your chance of delirium, which is a sudden change in your thinking or behaviour.

These medicines include:

• sleeping pills
• medicines for pain relief
• antidepressants or mood stabilisers
• anticholinergics (such as some antihistamines and medicines used for bladder control)

There are some things you can do to make sure that you use your medicines safely. These are:

• keep a current medicines list including vitamins and other complementary medicines
• ask your doctor questions about your medicines
• ask for a medicine review

Keep a medicines list

You can use a medicines list to keep track of:

• what each medicine (prescription and non-prescription) is for
• the dose (how much) of each medicine you take
• when to take each medicine
• how to take each medicine, for example some medicines you need to take with food

You can keep a medicine list by:

• writing down the names and amounts of each medicine you take on a piece of paper
• downloading and using a medicines list app on your smart phone
• asking your doctor or pharmacist for a medicine list at your next visit

Medicine lists help to make sure that everyone involved in your healthcare knows what you are taking.

Ask your doctor questions about your medicines

When getting a new medicine, you should ask your doctor or pharmacist these questions.

• Why do I need to take this medicine?
• Are there side effects?
• What should I do if I notice any side effects?
• What should I do if I don't feel like my medicine is working?
• Are there any things I need to do when taking this medicine, such as not driving?
• Does this medicine affect my other medicines? What about non-prescription medicines?
• Do I need to have blood tests to check how well the medicine is working?
• Is there a way to lower the number of medicines I'm taking?

Your doctor will consider your age when deciding if a medicine is right for you.

You can also talk to your doctor about other concerns you may have with your medicines. They may:

• change your dose
• change your medicine

NEVER stop taking your medicine without talking to your doctor.

You can try using a weekly dosing aid. This is a container that you can fill with your tablets each week.

If you're having trouble remembering which medicines to take when, talk to your pharmacist. They might be able to make you a pharmacy pack (also called a blister pack or a Webster pack). These help you take the right medicines at the right time.

Your pharmacist can also help answer any questions that you may have about your medicines.

Veterans

If you are a veteran you may be eligible for the Dose Administration Aid service. This service provides you with a medicine organiser pack. The pack will make it easier to take the right dose of medicine at the right time.

If you care for an older person you may notice they have problems such as:

• forgetfulness,
• confusion or they are
• feeling dizzy or unsteady.

These could be because of side effects from their medicines.

Talk to a doctor or pharmacist to see if any medicines might be causing problems.

Always talk to a doctor or pharmacist before stopping or changing any medicines.

• You can find out more about your medicines by reading the Consumer Medicine Information (CMI).
• Call 1300 MEDICINE on 1300 633 424 to speak with a pharmacist who can answer your questions about medicines.
• If you are a veteran, find out if you are eligible for the Dose Administration Aid service.
• NPS Medicinewise has information about medicine lists to help you keep track of the medicines you are taking.

Languages other than English

• NPS Medicinewise has factsheets with questions to ask your doctor about side effects from your medicines. These factsheets are available in languages other than English.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.